Elliot Rodger was seeing the psychiatrist from Celebrity Rehab and Flipping Out

For Charles Sophy, a Beverly Hills psychiatrist and television regular, clients from the showbusiness world are a staple of his business.

Paris Hilton, the party-loving hotel heiress, turned to him when she was in trouble with the law, the former Spice Girl Mel B praised his work in interviews, and he dispensed on-air expertise on shows such as Celebrity Rehab and Flipping Out.

So it was not unusual when Peter Rodger, a British film-maker based in Hollywood, asked him in late 2012 to meet his 21-year-old son, Elliot, a loner who seemed incredibly shy, particularly when it came to the opposite sex.

Sophy was one in a long line of psychiatrists, psychologists and counsellors who had seen Rodger since his parents first sought help when he was nine. He made no more progress than the others.

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For what neither his family, the mental health professionals, nor the police who called to check on him a few weeks ago identified was that Elliot Rodger was not just a deeply introverted young man. Rather, he was a violently disturbed individual, harbouring a hatred against the blonde students he believed were spurning him, and against society in general — especially women.

Even before he saw Sophy, he was planning what he called “the day of retribution,” as he revealed in a 137-page manifesto entitled “My Twisted World.” A series of videos on YouTube, with a tone that switched between swagger and self-pity, contained similarly sickening messages.

Last weekend, Rodger carried out his killing spree. He hacked to death his two male room-mates and a friend who had the misfortune to be visiting them at his student apartment in Isla Vista, near Santa Barbara on the Californian coast. He then went on a shooting rampage from his black BMW, killing two female students outside a sorority house, and another male student in a grocery store. He finally took his own life after he was wounded in two shoot-outs with police.

Rodger stopped seeing Sophy last year after the doctor prescribed himan anti-psychotic medication. “I refused to take it,” he wrote, “and I never saw Dr. Sophy again after that.”

But the psychiatrist was not the only Hollywood figure to whom the killer’s father, an assistant director on The Hunger Games, turned for help. He also approached his friend Dale Launer, a writer and director of several films about relationships, to try to teach his son some tips with women, according to the manifesto.

Launer may have enjoyed on-screen success with such sensitive plots as Blind Date and Love Potion No 9, but there was no breakthrough with Elliot Rodger. “He wanted to help me overcome my troubles because he is a so-called expert with women,” Rodger noted. “In truth, there is nothing men like Dale can really do to help me attract girls and lose my virginity. They can’t mind-control girls to be attracted to me.”

Sophy and Launer did not return requests for comment. Several others named in Rodger’s manifesto, including young women he claimed spurned him, and his few former male school friends, have spoken only to dispute his interpretation of their closeness.

While Rodger was unable to strike a chord with living individuals, he revelled in the luxuries of a life of private schools in Sussex, England, then Los Angeles. “We travelled on Virgin Atlantic Upper Class,” he noted on one occasion. “I was extremely enthusiastic about this, as I always loved luxury and opulence.” His social media pages were packed with images of him with the $40,000 black BMW 328i coupe his mother bought for him.

In another video, he gushed: “These sunglasses here are $300, Giorgio Armani. See? Look at how fabulous I look.”

However, as he filmed himself roaming Santa Barbara, he bemoaned his lonely existence — as all those around him were, in his eyes, enveloped in young love. “Look at them,” Rodger said to his camera phone, staring at a couple at a beach. “He’s in heaven right now, sitting on this beautiful beach, kissing her, feeling her love, while I’m sitting here alone, ’cause no beautiful girl wants to be my girlfriend.”

But what might have sounded like the angst of a young man morphed into uncontrollable rage. “I don’t know why you girls haven’t been attracted to me, but I will punish you, for it is an injustice,” he said. “I’ll take great pleasure in slaughtering all of you. You will finally see that I am the superior one, the true alpha male.”

Then there were, of course, the videos uploaded to YouTube and the manifesto — part David Copperfield, part Catcher in the Rye, part American Psycho. Minutes before embarking on his rampage, he emailed the document to up to 30 recipients, including a therapist, his family and internet acquaintances.

He was also a contributor on websites for male so-called “incels” — involuntary celibates — most notably on PUAhate, channelling hatred of successful “PUAs” or “pick-up artists”. He wrote in his manifesto that he had discovered “a forum full of men who are starved of sex, just like me”. What he read “confirmed many of the theories I had about how wicked and degenerate women really are.”

The atrocity has once again confronted America with the tragic consequences of mental health and access to guns, and it is raising fresh doubts about missed clues. Police knew of earlier disturbing videos Rodger posted online, but did not check them. The guns he used in the killings on May 23 were stashed inside his apartment, but police failed to search it or check whether he owned firearms, because they did not consider him a threat.

Chris Rugg, a former room-mate, said he had a “bad feeling” while living with Rodger and expressed regret that he did not help him. “I had my opportunity living with him when I knew things were up that I could have called in and it was my opportunity to help and I didn’t,” he said.

For Bianca de Kock, there are just the memories of the killer’s smile. The University of California student was walking home with two friends when a black BMW came out of nowhere, the window down.

The driver had a “smirky, grimacy smile”, Ms de Kock said. “He wanted to do this,” she told ABC News. “He looked happy about it.” After smiling, he opened fire. Ms de Kock survived the five bullet wounds. Both her friends died.